<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<title>押金催费</title>
</head>
<body>

<form action="to_addUrgeDeposit" method="post" id="UrgeDepositForm">
	<table class="chargeDeposittable" style="width: 100%; padding: 5px 3px;">
		<tr>
			<td width="50%"><input  style="width: 80%; " name="depositurgeid" id="urgeDepositID"
				class="easyui-textbox" label="押金催费号："  readonly="readonly"
				data-options="required:true"></td>
		</tr>
		
		<tr>
			<td width="50%"><input style="width: 50%;" name="patientname5" id="urgeDepositName" 
				class="easyui-textbox" label="病人姓名：" readonly="readonly"
				data-options="required:true"></td>
		  <td width="50%"><input  style="width: 50%;" name="liveoffice4" id="urgeDepositOffice"
				class="easyui-textbox" label="科室：" readonly="readonly"
				data-options="required:true"></td>
		</tr>
		
		<tr>
		  <td width="50%"><input  style="width: 60%;" name="depositlimit4"  id="urgeDepositAmount"
				class="easyui-textbox" label="押金额度："  readonly="readonly"
				data-options="required:true"></td>
		  <td width="50%"><input  style="width: 60%;" name="depositurgelimit" id="urgeDepositToAmount"
				class="easyui-textbox" label="催缴额度：" readonly="readonly"
				data-options="required:true"></td>
		</tr>
		
		
		<tr>
		  <td width="50%"><input  style="width: 70%;" name="depositurgedate"
				class="easyui-datebox" label="催缴日期："
				data-options="required:true"></td>
		  <td width="50%"><input  style="width: 70%;" name="limitdate"
				class="easyui-datebox" label="限缴日期："
				data-options="required:true"></td>
		</tr>
		
		<tr>
		
		  <td width="50%"><input  style="width: 80%;" name="liveid5" id="urgeDepositLiveID"
				class="easyui-textbox" label="住院号：" readonly="readonly"
				data-options="required:true"></td>
		  <td width="50%"><input  style="width: 80%;" name="admin4"
				class="easyui-textbox" label="经办人："
				data-options="required:true"></td>
		</tr>
	</table>
</form>




	<style type="text/css">
.chargeDeposittable td {
	padding: 4px 1px;
}
</style>
</body>
</html>